To evaluate left ventricular diastolic filling in patients with coronary artery disease, we analyzed high resolution time activity curves obtained from gated Tc99m radionuclide cineangiography at rest in 231 patients. Peak left ventricular filling rate (normal greater than or equal to 2.5 end-diastolic volume/sec) or time to peak filling rate (normal less than or equal to 180 msec) was abnormal in 90 percent of all patients with coronary artery disease, 86 percent of patients with normal left ventricular ejection fraction, 83 percent with normal ejection fraction without Q waves on ECG. Thus, left ventricular diastolic filling was abnormal in most patients with coronary artery disease independent of left ventricular systolic function, even in patients without evidence of prior myocardial infarction.